Thursday, August 6, 2009

Healthcare and Health Insurance

"I look at this health care plan and I see nothing that is about health or about care. What I see is a bureaucratic nightmare, senator. Medicaid is broke, Medicare is broke, Social Security is broke and you want us to believe that a government that can't even run a cash for clunkers program is going to run one-seventh of our U.S. economy? No sir, no," she said.

This Pennsylvanian lady could not have been more right. Despite the claims you hear coming from the White House and congress, healthcare is not a right and neither is health insurance. Let’s talk about the difference. Healthcare is a private industry that provides medical assistance from doctors and nurses for injuries and illness. The quality of healthcare has to do with the competence of your doctor and the facility they work in or for. Health insurance is the service you pay in order to help mitigate cost when you need healthcare. Both healthcare and health insurance are private industries and should be treated as such. Democrats are trying hard to connect the two and make you believe that through legislation you will somehow end up with a smarter, more polite doctor who never misses a diagnosis.

I know with Health Management Organization (HMO) type plans the difference between health insurance and healthcare is almost indistinguishable, but there is a difference. The United States has some of the best healthcare in the world because we have technological advancements, highly trained staffs, and highly educated health care professionals. The idea Democrats have is to convince you that your doctors’ ability to do his job will somehow be improved by their proposed bill. Nothing in their health insurance bill will help improve your healthcare. Your doctor will have the same IQ and training whether or not this bill gets passed. Your experience while meeting with the doctors’ staff will be the same if this bill gets passed. Your healthcare will not change. Do not get confused on this point because it is a key point when trying to understand this issue.

Let’s talk about the definition of a “right”. A right is something that is inherent or natural to a person for doing nothing more than existing. Basic rights for humans are privileges or liberties that all humans are entitled to. Your freedom of speech, religion, press, to keep and bear arms are all examples of laws that help protect your human rights like life, liberty, and the pursuit of happiness. The involvement of government in rights is to protect them. Not provide for them. We have the right of free speech but, the government shouldn’t buy each citizen a soapbox on which to stand and talk. We have the right to defend ourselves which is protected by the “right to keep and bear arms”, but the government is not required to provide each citizen a rifle.

Driving a car, eating at a restaurant, having a lawyer draft a contract, owning a house, having a painter paint your house, or having a doctor set a broken bone are not human rights. These are services that you pay for. Medical professionals are workers who provide a service. They have sought education, they have funded educations, they have worked to become qualified and informed in order to provide the service of health care. Just like anyone, they deserve to be paid for their expertise just like a lawyer is paid to know the law and a mechanic is paid to understand how to fix a transmission. Any demand of them beyond this is wrong. We do not have a right to be provided for financially and in essence, this is what is going on…medical welfare. The attempt to make this into a “human right” is just politics. Even if we concede the argument that citizens have the “right” to health care rather than just to want for health care, in no way does this mean that government has to provide citizens with health insurance to pay for it. They would just need to protect it. Do not get confused on this point either because this too is a key point when trying to understand this issue.

It is tiring seeing the innovation spawned of capitalism taken by society’s leeches to be provided to anyone as if they deserve it for more than the reason than they can afford it. Capitalism in the medical world resulted in innovations like MRIs, laparoscopic surgery, medications, and heart transplants. Those were possible by funding the research in the hope of future profit or capitalism. It would be a saccharine-sweet world if people did this kind of research/development out of the goodness of their heart, but I do not perform my job for free and neither do they. That is the reality. The feeling by the Democrat Party is these types of developments are something everyone deserves.

Here is reality: there is no difference between the business aspect of a doctor and of a painter. They both are selling their service. Clearly people value their health more than the exterior color of their house and it is more complicated to practice medicine than it is to paint a house therefore the doctor gets paid more for the service he provides. Why are we treating these entrepreneurs….yes, I had the gall to point out that a doctor is an entrepreneur…as slaves to our nation because of the field they decided to pursue? Medical professionals spend their own money and their own time to be able to do what they do. As soon as they are done, we as a nation immediately make unreasonable demands from them like having to provide their service for below market prices. This happens in no other industry and should not happen in theirs.

The latest line from Democrats is they don’t want universal health insurance; they just want a public option for health insurance. Well, except one of the most powerful and influential Democrats in congress, Barney Frank, who said in an interview that the public option will hopefully lead to universal healthcare. But let’s give them the benefit of the doubt for the purpose of this debate. The public option will require people to pay premiums, but it will be cheap enough for the 50 million people (this number is not my claim) who are uninsured because they cannot afford it and it will not deny you based on a preexisting condition. The best part is that it will not require you to drop your current insurance.

The government that can hardly manage…well, much of anything…is going to take 50 million people who are too poor to afford insurance or too much of a risk for insurance companies to take on and give them the same quality of health insurance for cheaper? And they are funding this by taxing a very small percentage of financially successful Americans, collecting tiny premiums, mandating doctors prescribe cheaper pills, and by not having to market their product or make a profit? Does anyone believe this?

The way insurance works is to put everyone in a pool…low risk all the way to high risk…and everyone pays some money. The higher of a risk you are, the more you pay which is why your car insurance rates go up when you do something risky like get into a car accident. When something happens to one of the people in this pool, there are funds available to help that person. By adding more people you are spreading the risk around. If you do get into an accident and your rates go up, there is usually another company ready to take you as a customer because they have calculated that they can afford to bring in more risk to the pool.

This being the case, how can this group of “50 million people” who cannot afford premiums and/or are extremely high risk possibly be a part of a self sufficient program with no tax payer subsidies, run by a government that has a horrible record when it comes to efficiency? High risk people or people with a pre-existing condition cost more to insure simply because they use medical services more. Rates are set because that is how much insuring the customer costs. Imagine having a car insurance company where everyone is a bad driver. Think it would last on artificially low rates?

Here is my favorite part. The Democrats are trying to make people believe that insurance companies are evil and that is why we have this problem. Then they are pointing to the fact that former insurance company executives love the public option therefore it is credible! Are these the same guys who ran the evil insurance companies who caused this “problem” in the first place? Because it can’t be both ways, Democrats.

Ideologically, health insurance and healthcare are not rights. Pragmatically, the Democrats proposal won’t work because this is not going to be a “deficit neutral” plan and it will cost tax payers dearly. Deficits…like government spending has caused since 2002 with a very special emphasis on the enormous deficit created in 2009, have drained our country of any ability to fund a luxury project like this. The Democrats are grasping at straws and deceiving the general public. In the end the idea straps you and me with a huge bill trying to solve an undefined problem in an industry that is already in regulatory trouble from government interference for a group of people that may not exist.

I am not even going to get in to the evil right-wing conspiracy that the liberals claim is going on at town halls across America. Every time someone disagrees with a liberal, they take it personally and feel attacked. Silliness.

Push Back:
Why do you make this a partisan issue and blame the Democrats? Normally I don’t take the side of any party, but in this case it is overwhelmingly…almost exclusively a Democrat initiative at a national party level.

Why are you criticizing without offering a solution? Normally my blog is all about solutions, but there is no clearly defined problem. Democrats have not done a good enough job defining the specific problems and this makes it hard to address anything other than their proposal. Democrats generally have no defined what it is specifically they are trying to fix. The cost? The quality? The availability? And specifically what is wrong about each and to whom this problem applies is not being addressed. The game plan from the Democrats is to throw out a number like “50 million uninsured” and then tell some horror story about a surgery gone wrong or a diagnosis that was missed. They finish that off by making doctors and insurance companies seem evil wanting to make money on their hard work. In this case, their proposal is conceptually wrong so the only solution is to vote “no”.

Why don’t Republicans have a counter offer? Again, offer to what? What is the problem? I know there are many proposals that Republicans are behind to improve the market conditions so insurances companies can be more competitive resulting in better prices and services for you, the consumer. Some of these are tort reform, opening up health insurance from other states, and simple tax rebates or grants so people can afford private insurance. The funny thing is these proposals by Republican congressman are not supported by the “evil insurance companies”. So…what does that mean to you? Clearly they are approaching it from a business standpoint and not a “right”. The Republican plans want the medical professionals to be involved in this process rather than congress just acting like an angry mob and demanding doctors perform for us or else. Medical professionals deserve a fair wage. In business it is always smart to get government out of the way.

1 comment:

  1. There are some problems in the health care field. Many doctors are quite unhappy, and recommend that their children do not follow them into the profession. Some of these complaints have to do with the irrationality of the payment schemes. Examples are the fact that a clerk in an insurance company can dictate, often after the fact, what the doctor is allowed to do in treating a patient, often as an urgent condition. Another is the very long, and unpredictable delay in reimbursement, sometimes with a letter sent to the patient implying that “your doctor overcharged you.” Also the reimbursement may be according to some fee schedule known only to the insurance company or to Medicare. A doctor colleague of mine just had his gall bladder out, somewhat of an urgent thing, as he had been having episodes of severe pain. He told me the surgeon charged about three thousand dollars, which he felt was fair. He just got the copy of the payment from Medicare, which paid the doctor about seven hundred dollars. That ratio, about fifteen percent or so, was what we saw at the hospital where I was a physician from Medicare and Medicaid. Sometimes the insurance people decided that we did not need to treat our patients and did not pay anything. A final problem that came to my mind, but by no means the only problem, is the malpractice situation. Malpractice has come to mean a bad outcome in many situations. While a person who is truly injured by a malpractice act should be compensated, the courts may award pain and suffering money in addition to actual expenses. There is no cap in many states on this pain and suffering award, which may be in the millions. Some of the best doctors are sued, as they may take the most difficult cases, and may work in teaching hospitals. At one point, and I don’t know that it has changed recently, a Florida ob-gyn might pay over $150,000 in malpractice premiums, as a baby he or she delivered can sue until the statute of limitations ends, which is, I think, three years after the baby reaches adulthood, or age 21.

    An Anonymous Dr.



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